RESUMO
INTRODUCTION: Currently, anterior cruciate ligament lesions have an increased frequency; their management is predominantly surgical; there are several functional assessment systems. MATERIAL AND METHODS: We used the IKDC (International Knee Documentation Committee) functional assessment in patients who underwent anterior cruciate ligament reconstruction at the Xoco Hospital Arthroscopy Service. RESULTS: A total of 73 patients underwent functional assessment; 43 underwent bone-tendon-bone (BTB) repair with patellar tendon graft and 30 underwent repair with pes anserinus tendon graft (T4). In the former group 39 patients had favorable results and 4 unfavorable results; in the latter group 27 patients had favorable results and 3 unfavorable results. DISCUSSION: The results found do not differ significantly between both groups, something that is in agreement with the reviewed literature. The study should be continued with a larger sample size to eliminate variables and obtain more reliable results.
Assuntos
Ligamento Cruzado Anterior/cirurgia , Artroscopia/métodos , Adulto , Ligamento Cruzado Anterior/fisiologia , Avaliação da Deficiência , Feminino , Hospitais Gerais , Humanos , Masculino , RegistrosRESUMO
Propôs-se caracterizar o perfil de utilização do diazepam na população idosa (60 anos ou mais) usuária crônica, atendida no serviço de atenção primária de Tatuí-SP e estabelecer uma relação entre uso crônico, efeitos adversos, dependência e as recomendações preconizadas na literatura científica. Desenvolveu-se um estudo observacional, transversal, através de entrevistas semiestruturadas aplicadas em 70 idosos. Trata-se de uma amostra não probabilística, por tipicidade, de caráter voluntário. A amostra selecionada era composta por: 77,1% mulheres e 22,9% homens, sendo, 37,1% casados, 44,2% viúvos, 92,8% de baixa escolaridade, 94,2% aposentados e 91,4% portadores de doenças crônicas. O diagnóstico referido, que justificou a prescrição inicial em dose de 10mg/dia foi a ansiedade e a insônia (92,8%). Em 90% dos pacientes a orientação médica foi seguida, sem interrupção, por um tempo mediano de 60 meses com um mínimo de seis e máximo de 360 meses. Os possíveis efeitos adversos foram: tontura, dores articulares, angústia e depressão. Aqueles que tentaram não utilizar o medicamento (97,14%) relataram insônia, ansiedade e irritabilidade. Os dados deste estudo, sugerem que a dose padronizada pela rede pública de 10mg e o tempo de utilização não propicia uma prática consistente de elevação do bem estar desses usuários, visto que a maioria relatou efeitos adversos e síndrome de abstinência na ausência do medicamento; tornando-se conveniente uma cuidadosa monitorização clínica e uma orientação quanto à redução gradativa da dose.
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Idoso , Atenção Primária à Saúde/estatística & dados numéricos , Diazepam/administração & dosagem , Diazepam/efeitos adversos , Centros de SaúdeRESUMO
In this study the effect of collagen-polyvinylpyrrolidone (collagen-PVP) vs. triamcinolone acetonide (Triam) in scleroderma (SSc) skin lesions was evaluated. Ten SSc patients were treated weekly with subcutaneous injections of 0.2 mL Triam (8 mg/mL) or 0.2 mL collagen-PVP (1.66 mg collagen). Skin biopsies were obtained from lesions before and after treatment. Tissue sections were evaluated by histology and immunohistochemistry (ELAM-1, VCAM-1, IL-1beta, TNF-alpha, TGF-beta1 and PDGF). The corticoid-treated group showed abnormal tissue architecture while the biodrug-treatment restored cutaneous appendages and type I/III collagen proportion. Cytokine and adhesion molecule expression was almost inhibited with Triam, while collagen-PVP down-regulated it. Collagen-PVP improved the tissue architecture of SSc lesions and down-regulated some proinflammatory parameters, without the side effects induced by corticoids.
Assuntos
Moléculas de Adesão Celular/metabolismo , Citocinas/metabolismo , Glucocorticoides/administração & dosagem , Povidona/administração & dosagem , Escleroderma Sistêmico/metabolismo , Triancinolona Acetonida/administração & dosagem , Adulto , Método Duplo-Cego , Regulação para Baixo , Selectina E/metabolismo , Feminino , Glucocorticoides/farmacologia , Humanos , Injeções Subcutâneas , Pessoa de Meia-Idade , Povidona/farmacologia , Escleroderma Sistêmico/tratamento farmacológico , Escleroderma Sistêmico/patologia , Pele/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Triancinolona Acetonida/farmacologia , Fator de Necrose Tumoral alfa/metabolismoRESUMO
In the last decade, evidence has accumulated to support the hypothesis that both mild and moderate elevations of serum prolactin (PRL) participate in the clinical expression and pathogenesis of systemic lupus erythematosus (SLE). Hyperprolactinemia (HPRL) has been found in 20-30% of patients with SLE. HPRL seems to be associated with clinical activity of SLE during pregnancy. Although the relationship between HPRL and active SLE in non-pregnant patients is controversial, recent clinical and experimental studies support the potential role of prolactin (PRL) as a promoter of clinical activity and severity of SLE. Mild elevations of serum PRL secondary to microadenoma could trigger the onset of SLE in a subset of patients. Elevated PRL and interleukin (IL)-6 have been found in the urine of patients with active lupus nephritis and in cerebrospinal fluid (CSF) of patients with active central nervous system (CNS) SLE. PRL may therefore participate in the pathogenesis of lupus nephritis and cerebritis, and the presence of PRL may reflect an abnormal communication between the immune system and the neuroendocrine system in active SLE. Lymphocytes from patients with active SLE produce increased amounts of PRL, and this extrapituitary PRL may participate in aberrant immune processes in SLE. There is exciting new evidence that HPRL in SLE may be explained by stimulation of pituitary PRL secretion by cytokines. In addition, defects in peptidergic modulators and dopamine metabolism have been described in patients with SLE. The interactions between PRL, cytoquines, autoantibodies and organ involvement suggest that PRL participates in local and generalized immune and inflammatory processes and acts as a bridge between the neuroendocrine and immune systems in SLE. Understanding the interactions between these systems in SLE will help us to understand and treat this important autoimmune disease.
Assuntos
Lúpus Eritematoso Sistêmico/metabolismo , Lúpus Eritematoso Sistêmico/fisiopatologia , Prolactina/metabolismo , Autoanticorpos/imunologia , Sistema Nervoso Central/imunologia , Sistema Nervoso Central/metabolismo , Sistema Nervoso Central/fisiopatologia , Humanos , Hiperprolactinemia/imunologia , Hiperprolactinemia/metabolismo , Hiperprolactinemia/fisiopatologia , Lúpus Eritematoso Sistêmico/imunologia , Nefrite Lúpica/imunologia , Nefrite Lúpica/metabolismo , Nefrite Lúpica/fisiopatologia , Especificidade de Órgãos , Prolactina/imunologiaRESUMO
El rabdomiosarcoma es una neoplasia derivada de células mesenquimatosas. La ubicación primaria perianal es muy rara y tiene mal pronóstico. Se reporta el caso de una mujer joven con rabdomiosarcoma embrionario perianal, con adecuada respuesta inicial a radio y quimioterapia combinada y que más tarde desarrolló metástasis mamaria y ósea, así como compresión medular.
Assuntos
Humanos , Feminino , Adolescente , Canal Anal , Períneo , Rabdomiossarcoma , Metástase NeoplásicaRESUMO
Actualmente se considera que un tercio de la población humana se encuentra infectado por Mycobacterium tuberculosis. La tuberculosis mimetiza toda una variedad de padecimientos y, en el caso de su variante peritoneal que comprende del 0.7 al 2 por ciento de todos los casos registrados, puede comportarse clinicamente como cualquier otra patología abdominal. Por su parte, el vólvulo de sigmoides constituye una entidad con amplias variaciones geográficas, con una prevalencia de 0.2 por ciento en Occidente y con una tasa de mortalidad considerable del 30 por ciento. De etiología incierta, se relaciona con variaciones anatómicas, régimen dietético, constipación crónica, procesos inflamatorios localizados, enfermedades neurológicos, adherencias posquirúrgicas, embarazo, toxinas y enfermedades metabólicas. Presentamos un caso clínico en el que se conjugan estas dos patologías
Assuntos
Humanos , Masculino , Adulto , Colo Sigmoide/anatomia & histologia , Peritonite Tuberculosa/diagnóstico , Peritonite Tuberculosa/patologia , Obstrução Intestinal/patologia , Saúde Global , Fatores de Risco , Infecções por Mycobacterium/patologiaRESUMO
We report four new cases of chordoma of "the mobile spine", all at the L2 level. Diagnosis was often delayed due to predominantly nonspecific low back symptoms; however, neurological involvement is more frequent than in chordoma with a sacrococcygeal localization. No pathognomonic images have been described for any imaging modality, and differential diagnosis should include metastases, chondrosarcoma, and giant-cell tumor. Histopathological analysis can be performed on CT-guided puncture biopsy samples, but a high level of suspicion must be present and, if there is any doubt, immunohistochemical studies should be carried out. Despite being the treatment of choice, complete tumor resection by a double-approach spondylectomy is barely feasible at the L2 level.
Assuntos
Cordoma , Vértebras Lombares , Neoplasias da Coluna Vertebral , Idoso , Cordoma/diagnóstico , Cordoma/epidemiologia , Cordoma/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/epidemiologia , Neoplasias da Coluna Vertebral/cirurgiaRESUMO
BACKGROUND: Fogo selvagem (FS) is an autoimmune disease that is endemic in certain regions of Brazil and appears to be precipitated by an environmental factor. OBJECTIVE: Our purpose was to confirm the occurrence and prevalence of FS in a population of Xavante Indians living in an endemic region of central Brazil. METHODS: Clinical, anthropologic, and immunologic studies were carried out in patients and in normal inhabitants of the Pimentel Barbosa Indian Reservation, Mato Grosso, Brazil. RESULTS: FS was identified and confirmed in 10 patients from a patient pool of 295 with various skin diseases. The Xavante settlement has a total population of 746. Anti-desmoglein 1 autoantibodies were detected in all patients with FS and were absent from more than 300 serum samples collected from randomly selected unaffected persons. CONCLUSION: FS is strongly linked to outdoor activities and is largely restricted to immunogenetically predisposed persons. FS appears to have been endemic in certain regions of South America for several centuries.